Insurance companies today complete insurance claims using company practices with the hopes of settling claims for an appropriate sum. Any audits that are conducted on the claims processing are conducted either manually or by using a system which can only calculate basic information including the number of claims processed by any particular claim handler, the amounts paid out on claims and the time frame for processing claims.
This type of information is not sufficient in determining whether claims are being processed efficiently and cost effectively. There are limited means, which are costly and time consuming, to calculate whether an insurance company is properly paying out on claims without overpaying. Further, it is difficult to calculate whether claims handlers are using the best methods for streamlining the claims handling process.
As such, there is a need for a system which can review the claim handling process more completely in order to give an insurance company an idea of what company practices are beneficial, whether the amount paid out on the claims were appropriate, and whether claims are being handled efficiently and properly.